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Children 2017, 4(11), 98; https://doi.org/10.3390/children4110098

Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation

1
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
2
Pain/Stress Neurobiology Laboratory, Department of Pediatrics, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
3
Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
4
Departments of Pediatrics, Anesthesiology, Perioperative & Pain Medicine, Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
Received: 17 August 2017 / Revised: 3 November 2017 / Accepted: 8 November 2017 / Published: 15 November 2017
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Abstract

Background: We report the prevalence of children with multiple medical symptoms in a pediatric neurology clinic, describe their symptom profiles, and explore their association with adverse childhood experiences (ACEs). Methods: We retrospectively reviewed 100 consecutive patients from an outpatient pediatric neurology clinic. Patients were included if they were ≥5 years old and reported ≥4 symptoms that were unexplained for ≥3-months. Symptom profiles across six functional domains were recorded: (1) executive dysfunction, (2) sleep disturbances, (3) autonomic dysregulation, (4) somatization, (5) digestive symptoms, and (6) emotional dysregulation. ACEs were scored for all patients. Results: Seventeen patients reported ≥4 medical symptoms. Somatization, sleep disturbances, and emotional dysregulation occurred in 100% patients, with executive dysfunction (94%), autonomic dysregulation (76%), and digestive problems (71%) in the majority. Forty-two children reported ≥1 ACE, but children with ≥4 symptoms were more likely to report ACEs compared to other children (88% vs. 33%; p < 0.0001) and had a higher median total ACE score (3 vs. 1; p < 0.001). Conclusions: Children with multiple medical symptoms should be screened for potential exposure to ACEs. A clinical profile of symptoms across multiple functional domains suggests putative neurobiological mechanisms involving stress and nervous system dysregulation that require further study. View Full-Text
Keywords: child; nervous system; psychosomatic; stress; adverse childhood experiences child; nervous system; psychosomatic; stress; adverse childhood experiences
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Elbers, J.; Rovnaghi, C.R.; Golianu, B.; Anand, K.J.S. Clinical Profile Associated with Adverse Childhood Experiences: The Advent of Nervous System Dysregulation. Children 2017, 4, 98.

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